Healthcare Provider Details

I. General information

NPI: 1346279718
Provider Name (Legal Business Name): JONATHAN R. STRAYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W GALBRAITH RD DRAKE CENTER
CINCINNATI OH
45216-1015
US

IV. Provider business mailing address

260 STETSON STREET ML 0530 SUITE 5200
CINCINNATI OH
45267-0530
US

V. Phone/Fax

Practice location:
  • Phone: 513-418-2707
  • Fax: 513-418-2698
Mailing address:
  • Phone: 513-558-2919
  • Fax: 513-558-4458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35-082255
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number35-082255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: